Meta-Analysis of Oral Anticoagulant Monotherapy as an Antithrombotic Strategy in Patients With Stable Coronary Artery Disease and Nonvalvular Atrial Fibrillation
Section snippets
Methods
We performed electronic searches of PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to identify studies that included specific keywords relevant to this topic. We added manual search results, including references cited in electronically searched articles, recent reviews, editorials, and meta-analyses. We did not apply any restrictions regarding the language, study period, or sample size. A description of the detailed study methods including search strategy is included in the
Results
Figure 1 presents an overview of the search and selection process used in this meta-analysis. A total of 8,855 patients with stable CAD and nonvalvular AF were included in the 6 studies. A summary of important study characteristics can be found in Table 1 and eTable 4 in the online supplement. Only recent publications included direct oral anticoagulant (DOAC) users (27%, 40.6%, and 24.8% of total study population).9, 10, 11 Patients with DOAC accounted for 8.6% of total of 8,855 pooled
Discussion
Our principal findings are as follows: (1) the pooled HR for major bleeding and NAE were significantly higher in the OAC plus SAPT group, whereas there were no significant differences in MACE, stroke, and death; (2) in general, consistent findings were observed in various subgroup analyses, including BMS and DES studies; (3) OAC monotherapy showed more benefit for MACE in the subgroup with higher proportion of previous MI patients; (4) in the studies after the introduction of DOACs, OAC
Disclosures
SRL, TMR, DYK: none; EKC: research grant from Daiichi-Sankyo, BMS/Pfizer, and Biosense Webster; SO: research grant from Bayer Korea, BMS Korea, Boehringer-Ingelheim Korea, Daiichi Sankyo Korea, Pfizer Korea. No fees are received personally; GYHL: consultant for Bayer/Janssen, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Novartis, Verseon and Daiichi-Sankyo. Speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are received personally.
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Cited by (0)
Funding: None.
- 1
Drs. Lee and Rhee contributed equally to this work and are joint first authors.
- 2
Drs. Oh and Lip contributed equally to this work and are joint senior authors.